Lecture 5- therapeutic angiogenesis Flashcards
what is the principle cause of death in the world
CVD (50%)
what is the major cause of CVD
atherosclerosis
what are the non-modifiable risk factors for CVD
Age Sex (male) family history
what are the modifiable risk factors for CVD
smoking, hypertension, diabetes, obesity, high cholesterol
what are the clinical manifestations of CVD
chronic, angina, heart attack, stroke, peripheral arterial disease (PAD)
how is narrowing of blood vessels visualised
angiogram
what are the symptoms of PAD
initially long distance claudication (difficulty walking long distances) limited functionality, chronic pain, ulcers and gangrene
once a foot ulcer occurs in PAD, what is the outlook for the patient
50% chance of being alive with 2 legs in a years time and 30% chance of survival after 5 years
how is PAD diagnosed
history, examination, ankle-brachial bp index, angiogram
what are the surgical methods for treating PAD
endovascular treatments using catheters and balloons, open surgery to clear out blood vessels, bypass and finally amputation
how can therapeutic angiogenesis used to treat PAD
administration of pro-angiogenic growth factors to stimulate proliferation of blood vessels and improve perfusion
how are growth factors delivered for angiogenic therapy
they can be injected into cells via plasmids or viruses or directly injected into arteries
what have been the results using IMVEGF-A gene therapy
positive showing wider blood vessels and healing ulcers
what have been the results of FGF-1 gene therapy
no significant difference in 2nd or 3rd stage clinical trials- may need higher doses or to be taken longer or perhaps a single growth factor is not sufficient
what have been the results of hepatocyte growth factor gene therapy trials
phase 2 clinical trial very successful so should begin phase 3 soon
